Medical practices
Know who you’re billing with before Medicare does.
Look up any provider’s NPI and see in the same result whether they’re barred from federal health programs. Screen staff without an NPI too. Official CMS and OIG data, free.
- Patient and claim reference
- Why the service is necessary
- Coverage criteria and records cited
- Request for reconsideration
Tools
Compliance checks that take seconds, not afternoons.
NPI lookup with OIG exclusion check
Search the CMS NPI Registry; every result is checked against the OIG exclusion list automatically.
Open tool →Live · FreeOIG exclusion check
Screen staff, contractors and vendors by name against the OIG list, with a dated record to save.
Open tool →Prior authorization and appeal letter builder
Insurer, service and denial reason in; a structured appeal with the insurer’s deadline and an enclosures checklist out.
Medicare coverage criteria finder
Enter a service and get Medicare’s coverage criteria as a documentation checklist.
Authorization and appeal deadline tracker
Every open authorization and appeal with due dates and reminders, using case numbers, not names.
Patient denial appeal letter
For patients: what was denied in, an appeal letter, the deadline and your state’s external review route out.
What most practices don’t know
One excluded employee can cost more than a year of compliance.
per item or service is the maximum civil penalty for billing federal health programs through someone you knew or should have known was excluded, plus up to 3 times the amount claimed.
Source: 42 U.S.C. § 1320a-7a (civil monetary penalties)of the 84,094 people and businesses on OIG’s exclusion list include an NPI. Searching by NPI alone misses about 94% of them, so name checks matter.
Source: HHS OIG, LEIE downloadable databasecounts, not just clinicians. OIG’s rule covers anyone you hire whose work is paid for directly or indirectly by Medicare or Medicaid, including billing and administrative staff.
Source: HHS OIG, Background Information and Exclusion AuthoritiesPractice Pro · in development
Monthly screening for your whole team, done for you.
$79 a month per practice, planned price
Pro is not available yet. The NPI lookup and exclusion check are complete and will stay free.
- Upload your staff and vendor list once; everyone is re-screened every month
- Email alert the day a possible match appears, with the evidence
- Dated PDF screening records for audits and payer credentialing
- SAM.gov and state Medicaid exclusion lists added to every check
- Prior authorization and appeal letter builder
Questions
Who are these tools for?
Physician practices, clinics, therapy and home health agencies, billing companies and credentialing staff in the United States.
Is the data official?
Yes. NPI results come live from the CMS NPPES NPI Registry, and exclusion checks use the HHS OIG List of Excluded Individuals and Entities, refreshed from OIG’s monthly file.
Are the tools free?
The NPI lookup and exclusion check are free with no account. Practice Pro, in development, adds automatic monthly screening of your whole staff and audit-ready records.
Do you store the names I search?
No. Searches aren’t saved, and the exclusion check runs in your browser.